UnitedHealth Group-posted 7 months ago
$16 - $28/Yr
Full-time • Entry Level
Remote • Eau Claire, WI
Insurance Carriers and Related Activities

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. In this role, you'll be responsible for reviewing and making adjustments or corrections to processed claims through researching, investigating issues, making a determination and then communicating as required. Using multiple platforms, you'll also assist with pricing verification, prior authorizations, benefits and coding. Join us and build your career with an industry leader. This position is full-time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00 AM - 6:00 PM candidate's local time zone after core metrics are met. It may be necessary, given the business need, to work occasional overtime or weekends. We offer 14 weeks of paid training. The hours of the training will be 7:00 AM - 3:30 PM CST from Monday - Friday. 100% attendance is required and No PTO during training. Training will be conducted virtually from your home.

  • Update claim information based on research and communication from member or provider
  • Complete necessary adjustments to claims and ensure the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g., claims processing policies and procedures, grievance procedures, state mandates, CMS / Medicare guidelines, benefit plan documents / certificates)
  • Communicate extensively with members and providers regarding adjustments to resolve claims errors / issues, using clear, simple language to ensure understanding
  • Learn and leverage new systems and training resources to help apply claims processes / procedures
  • High School Diploma / GED OR equivalent work experience
  • Must be 18 years of age OR older
  • 1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.), using phones and computers as the primary job tools
  • Ability in using computer and Windows PC applications, which includes keyboard and navigation skills and learning new computer programs
  • This position requires full attention to work duties. Employees in this role must ensure they have uninterrupted work time during their shifts, except for scheduled breaks and lunch periods.
  • Ability to work any of our full-time (40 hours / week), 8-hour shift schedules during our normal business hours of 6:00 AM - 6:00 PM candidate's local time zone from Monday - Friday after core metrics are met. It may be necessary, given the business need, to work occasional overtime or weekends.
  • Presently employed within UHC Operations & Experience.
  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution
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